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How to recognise the signs of ovarian cancer

Difficult to detect, ovarian cancer is silently taking the lives of Australian women. Here’s what you need to know.
Woman in pain
Ovarian cancer has the lowest survival rate of any women’s cancer. Image: Getty

It was a routine scan for recurring sciatica pain that would upend the life of West Australian hairdresser Kate Wylie. In late 2023, the 33-year-old noticed a niggling pain in the back of her leg. Having been treated for sciatica five years earlier, she assumed it had returned. However, upon receiving her scan results, the doctor mentioned a mass.

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“The tumours were visible from the scan,” Kate says of the appointment that quickly pivoted from sciatica treatment to a referral to a gynaecologist. It was where she received a diagnosis of low-grade serous ovarian cancer.

“It was a rollercoaster because they didn’t say, ‘You’ve got cancer’, they just mentioned that there were tumours — I was thinking maybe it’s just endo [endometriosis] or polycystic ovarian syndrome [PCOS].”

But further scans soon confirmed her worst fears. Furthermore, along with the upheaval of a cancer diagnosis, and despite the classification “low-grade”, Kate would soon be losing her reproductive organs. And with them, any chance of carrying a baby.

Kate’s diagnosis was the result of a routine scan for recurring sciatica pain. Images: Supplied
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Statistics from Ovarian Cancer Australia paint a worrying picture. With five women diagnosed each day, ovarian cancer has the lowest survival rate of any women’s cancer. Just 49 per cent of women with the disease survive five years. This is largely because many cases aren’t diagnosed until they reach an advanced stage.

However, there are important distinctions. “Ovarian cancer is a broad term, with low-grade tumours like Kate’s treated differently to high-grade tumours,” explains Dr Nikki Burdett, ovarian cancer researcher and medical oncologist at Peter MacCallum Cancer Centre. This means that both treatment and survival rates vary, with a lower rate of survival for high-grade cancers.

The fight for early detection

As heartbreaking as the current statistics may be when diagnosed in its early stages, women have a 90 per cent chance of being alive and well after five years. However, we face an uphill battle when it comes to early detection. Although research is ongoing, there isn’t yet an effective screening test for ovarian cancer, explains Dr Orla McNally, Director of Gynaecology Oncology at the Royal Women’s Hospital and Associate Professor in the Department of Obstetrics and Gynaecology at the University of Melbourne. She says that one challenge with early detection is that, unlike other gynaecological cancers, when most women begin experiencing symptoms, ovarian cancer has often already spread outside of the ovaries or fallopian tubes.

Dr Burdett points out a common misconception, that the cervical screening test, or “Pap smear”, will also detect ovarian cancer. “While there are very rare examples of this, it’s not designed to and will not pick up the majority of ovarian cancers.”

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Know the signs of ovarian cancer

Symptoms of ovarian cancer will vary depending on what structures in the body are affected, explains Dr Burdett, “but loss of appetite or weight, bloating, nausea, abdominal or back pain, and change in bowel habit or frequent urination are common.”

According to Ovarian Cancer Australia, ovarian cancer can affect women of all ages. However, it is most common in women over 50 years of age who have been through menopause. The average age of diagnosis is 64.

“One of the challenges,” Dr McNally explains, “is that the symptoms are also very common around the time of the menopause.” Between weight gain, the impacts of low oestrogen levels and the bowel becoming more sluggish, she says it’s easy for these signs and symptoms of ovarian cancer to be dismissed as those commonly experienced in menopause.

How ovarian cancer can be treated

The standard treatment for ovarian cancer is most commonly surgery followed by chemotherapy. But Dr McNally says that worldwide research has made it clear that where you get treatment really matters. “There’s plenty of evidence that if a woman has her surgery with a gynae-oncologist, she’ll do better than with a gynaecologist, and actually better than if she’s with a colorectal surgeon,” she says.

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Woman with cancer thinking
Five Australian women are diagnosed with ovarian cancer every day. People often don’t understand what the signs of ovarian cancer are. Image: Getty

So, for women living in rural or remote areas, lack of access to larger centres and specialist care can put them at a severe disadvantage.

According to Dr Burdett, it’s impossible to properly articulate the psychological impact an ovarian cancer diagnosis can have on women. “It’s enormous. Women are often the ‘glue’ in their family and societal circles, and trying to keep up all those roles while going through physically trying treatment is exhausting.”

It’s something that Kate is only now beginning to process. After being flung into an immediate and all-consuming eight-month treatment process, involving a full hysterectomy and multiple rounds of chemotherapy, she says it’s only now that her new reality is starting to sink in.

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“My surgeon said that he couldn’t tell in the biopsy whether the tumour was resting on my bowel or if it had invaded my bowel,” she explains. “They said, ‘We put a smiley face on your belly for where the stoma bag is meant to go’ and I just remember waking up and saying, ‘Oh, do I still have a smiley face, or is there a bag there?’”

A stoma is a small external opening in the bowel where waste can be removed. Waking up from surgery with the realities of medical menopause, including immediate hot flushes, Kate learned that the smiley face sticker had been replaced by a stoma bag. But the biggest impact, she says, has been adjusting to the reality of losing her fertility.

“I’m not scared of the cancer. I’m just scared of the future and what’s happened to me now.”

A shot at prevention

While there is currently no screening for detecting ovarian cancer available for someone without showing signs or symptoms, there are some protective measures that help.

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“We now know that any usage of the Pill reduces your risk of ovarian cancer,” says Dr McNally, with use of up to 10 years providing mounting protection.

Another option for women identified as “high risk” for the disease, either through family history or the BRCA gene mutation, is known as risk-reduction surgery. Dr McNally says this is where women can have their fallopian tubes and ovaries removed at an age where their risk starts to increase.

“The big downside, of course, is that they’re put into menopause much earlier than would otherwise happen,” she says.

Let there be light

During treatment, Kate was operating on “autopilot”. Back at work as a hairdresser in between rounds of chemotherapy, she hardly had time to register the loss of her own hair. “I was wearing a shitty wig,” she says. “I couldn’t do scarves or anything because I just didn’t want to be looked at like the sick one.”

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But the experience seeded a new venture, and Kate and a colleague started a business producing customised wigs for other women experiencing hair loss. Despite being less than 12 months on from a world-upending diagnosis, Kate set about making the path gentler for women walking it behind her.

“I don’t want any woman to have to go through this at 30, or at any age, so if there’s a way I can make it easier for others, I want to do that.”

Symptoms and signs of ovarian cancer to look out for:

  • Increased urinary frequency.
  • Stomach distension, or ‘bloating’.
  • Appetite loss.
  • Unexplained weight loss.
  • Nausea.
  • Abdominal and/or back pain.
  • Changes in bowel habits.
  • Pain or bleeding during/after sex.

Visit ovariancancer.net.au for information and support, or call 1300 660 334 to speak with an ovarian cancer nurse.

This article originally appeared in the February 2025 issue of The Australian Women’s Weekly. Pick up the latest issue from your local newsagents or subscribe so you never miss an issue.

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